Poster 199 Vibration Elastography to Assess the Effect of Dry Needling on Myofascial Trigger Points in Patients Affected by Myofascial Pain Syndrome

Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed.

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Clinical criteria for the application of dry needling in myofascial pain Syndrome: An expert consensus document and a cross-sectional study among physical therapists

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3402788 ◽

2019 ◽

Vol 02 (02) ◽

pp. 050-054

Author(s):

Nicolas Secorro ◽

Rafael Guerra ◽

Xavi Labraca ◽

Marc Lari ◽

Daniel Pecos ◽

...

Keyword(s):

Physical Therapy ◽

Myofascial Pain ◽

Panel Discussion ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Cross Sectional ◽

Myofascial Trigger Points ◽

Clinical Criteria

AbstractPresently, there is no clear consensus on the essential and confirmatory criteria which should govern the application of dry needling (DN) in the treatment of myofascial trigger points. The aim of this study was to generate a consensus on these criteria, via a panel discussion with DN experts which took place at the International Conference of Invasive Physical Therapy held in 2018, including the opinion of the attendees who participated in a live survey on the subject at the conference via an app. The results obtained reveal discrepancies regarding confirmatory criteria such as the elicitation of referred pain; nonetheless, consensus exists on the suitability of the application of individualized and personalized DN treatment and the combination of treatment with other intervention approaches in physical therapy, with the use of ultrasound when required to support a safer clinical practice.

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Dry needling versus ultrasonic in treating cervical myofascial pain syndrome

QJM ◽

10.1093/qjmed/hcaa064.005 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

H A Ali ◽

A K Elzohiery ◽

M M Arafa ◽

N A Elkadery

Keyword(s):

Skeletal Muscles ◽

Myofascial Pain ◽

Trigger Point ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Ultrasonic Waves ◽

Dry Needling ◽

Myofascial Trigger Points

Abstract Background Myofascial pain syndrome (MPS) is a complex pain syndrome characterized by myofascial trigger points (MTrPs) in skeletal muscles. Ultrasound (US) therapy is one of the main devices used in physical therapy, for the treatment of MTrPs in MPS. Dry needling is skilled technique also used in the treatment of MTrPs in MPS. Purpose This study aimed to compare the effect of dry needling with the effect of ultrasonic waves in the treatment of cervical myofascial pain. Subjects a sample of 30 patients with myofascial trigger points in trapezius muscle was randomly chosen and divided into 2 groups each contains 15 patients. Methods the first group was treated by ultrasonic waves in a pulsed mode (1MHz, 1W/cm², 1:1 ratio) 5 min to each trigger point and the second group was treated with deep dry needling (peppering technique) to each trigger point with a rate of 3 times per week for 3 weeks. Results All patients shows significant improvement (P > 0.001) immediately after treatment period with disappearance of trigger points, increasing in cervical ROM and decreasing in VAS ; but 3 weeks later trigger points reappeared, ROM decreased and VAS increased again. Conclusion both modalities of treatment were considered effective in treating myofascial pain syndrome.

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Effectiveness between Dry Needling and Ischemic Compression in the Triceps Surae Latent Myofascial Trigger Points of Triathletes on Pressure Pain Threshold and Thermography: A Single Blinded Randomized Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm8101632 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1632 ◽

Cited By ~ 6

Author(s):

Benito-de-Pedro ◽

Becerro-de-Bengoa-Vallejo ◽

Losa-Iglesias ◽

Rodríguez-Sanz ◽

López-López ◽

...

Keyword(s):

Skin Temperature ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Pain Syndrome ◽

Trigger Points ◽

Triceps Surae ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Pressure Pain

Background: Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition. Objective: To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements. Method: A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN (n = 17) or ICT (n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment. Results: Statistically significant differences between both groups were shown after treatment, showing a PPT reduction (p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences (p > 0.05) for thermographic values before and treatment for both interventions. Conclusions: Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes’ population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition.

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Evaluation of the Analgesic Effect of Combination Therapy on Chronic Plantar Pain Through the Myofascial Trigger Points Approach

Journal of the American Podiatric Medical Association ◽

10.7547/16-038 ◽

2018 ◽

Vol 108 (1) ◽

pp. 27-32 ◽

Cited By ~ 2

Author(s):

Rocío Melero-Suárez ◽

José Antonio Sánchez-Santos ◽

Gabriel Domínguez-Maldonado

Keyword(s):

Combination Therapy ◽

Analgesic Effect ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Adductor Muscle ◽

Rank Test ◽

Myofascial Trigger Points

Background: Closely related pathologic disorders sometimes manifest with the same symptoms, making for a complex differential diagnosis. This is the situation in plantar fasciitis (PF) and myofascial pain syndrome (MPS) with myofascial trigger points (MTPs) in the sole of the foot. This research assessed the analgesic effect on plantar pain of combination therapy with interferential current stimulation therapy (ICST), treating MTPs in the great toe adductor muscle and the short flexor muscles of the toes in patients whose diagnosis was compatible with PF or MPS. Methods: This study included 22 feet of 17 patients with a diagnosis compatible with PF or MPS with MTP. Participants received combination therapy with ICST for 15 sessions, and the decrease in pain was measured with an algometer and the visual analog scale. Both measurements were taken before and after every fifth session. The pressure pain threshold (PPT) results obtained with the Student t test and the pain intensity perception (PIP) results obtained with the Wilcoxon signed rank test were analyzed by comparing the measurements taken before the treatment and after the fifth, tenth, and 15th sessions. Results: The decrease in PIP was significant after the fifth, tenth, and 15th sessions (P < .001). The increase in PPT was also significant after the fifth (P = .010), tenth (P = .023), and 15th (P = .001) sessions (P < .05). Conclusions: The suggested combination therapy of ultrasound with ICST is clinically significant for reducing plantar pain after 15 treatment sessions, with a 6.5-point reduction in mean PIP and a 4.6-point increase in PPT.

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Results of the post-registration clinical study “PARUS” on efficiency and safety assessment of Mydocalm-Richter for local injection therapy of a myofascial trigger zone

Terapevticheskii arkhiv ◽

10.26442/terarkh201890681-88 ◽

2018 ◽

Vol 90 (6) ◽

pp. 81-88

Author(s):

F I Devlikamova

Keyword(s):

Muscle Relaxant ◽

Blood Circulation ◽

Myofascial Pain ◽

Ultrasound Examination ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Orthostatic Test ◽

Myofascial Trigger Points ◽

Sedative Effects

Aim. The “PARUS” program included investigation of the analgesic, muscle relaxant and sedative effects of Mydocalm-Richter which acts as central muscle relaxant in patients with myofascial pain syndrome, taking into account its registered indication for use - the hypertonus and cross-striated muscle spasm. Materials and methods. Fifty patients with myofascial trigger points, the mean age of 41.67±11.86 years, have been enrolled in the study. All patients had undergone clinical examination that allowed the diagnosis of myofascial pain syndrome. The intensity of pain syndrome was evaluated using the pain visual analogue scales and McGill pain questionnaire. Visualization of area in spasm and evaluation of blood circulation was carried out using the ultrasound scan of target muscle. In order to objectively evaluate any conceivable hypotensive and sedative effects of Mydocalm-Richter we used the orthostatic test, Schulte’s test for attention span and perfor-mance distribution and Munsterberg’s test for attention discrimination and concentration. Results. The analgesic and muscle relaxant effects of Mydocalm-Richter become apparent by day 3 post-injection, and the muscle relaxation effect is reaching its maximum on day 10 post-injection. Cardiovascular function following administration of Mydocalm-Richter was evaluated using the orthostatic test which revealed good orthostatic tolerance. Single injection of tolperisone hydrochloride possessing a central muscle relaxant activity has no sedative effect and does not influence patient response time. The ultrasound examination data demonstrated the improvement and in some cases restoration of blood circulation in the myofascial trigger points. Conclusion. Clinical study “PARUS” conducted in patients with myofascial pain has demonstrated a positive muscle relaxant and analgesic effect of Mydocalm-Richter that resulted in restoration of peripheral circulation in the myofascial trigger pointsconfirmed by ultrasound examination. An important benefit of this drug product is the absence of sedative effect and arterial hypotension.

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The relative effectiveness of a home programme of ischaemic compression, sustained stretch and a combination of both for the treatment of myofascial trigger points in the upper trapezius musculature

10.51415/10321/2738 ◽

2003 ◽

Author(s):

◽

Marlon Thoresson

Keyword(s):

Myofascial Pain ◽

Relative Effectiveness ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Clinical Findings ◽

Myofascial Trigger Points ◽

Upper Trapezius

The purpose of this study was to determine the relative effectiveness of a home programme of ischaemie compression, sustained stretch and a combination of the two, in terms of subjective and objective clinical findings for the treatment of Myofascial Pain Syndrome.

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